Carl Zeiss establishes another milestone in refractive corneal surgery

At the recent ESCRS meeting in Vienna, Carl Zeiss Meditec presented its ReLEx® smile correction technique, a minimally invasive laser technique for the correction of refractive errors. Unlike LASIK, in which tissue is ablated with an excimer laser after opening a flap, ReLEx smile does not require a flap. Instead, it creates a lenticle inside the intact cornea, which is removed through a small incision. Carl Zeiss thus establishes another milestone in refractive corneal surgery. Dr. Ludwin Monz, President and CEO of Carl Zeiss Meditec AG: “The ReLEx smile minimally invasive treatment method is pioneering and has the potential to herald a paradigm shift in refractive laser surgery.”


Refractive methods without a flap enable doctors to operate precisely, minimally invasive and therefore gently. The femtosecond laser precisely creates a lens-shaped lenticle in the cornea, which is then removed in one piece through a four-millimeter incision. A flap, as required with most existing procedures, is no longer made in the cornea and opened. Unlike existing LASIK treatments, ReLEx smile requires an 80 percent smaller surface incision in the upper cornea (flap-side cut) and an about 30 percent smaller lamellar incision (cap cut surface). The biomechanical stability of the vital upper layers of the cornea remains largely intact. For the patient, this means a gentle, minimally invasive operation. Thanks to the minimized severance of nerve pathways, this technique may result in a lower occurrence of dry-eye syndrome which is a common side effect of laser procedures.

Treatment with only one femtosecond laser – all-femto.

With ReLEx, defective vision can be treated with just a single femtosecond laser – the VisuMax® from Carl Zeiss – for the very first time. Because the treatment by cutting instead of ablation occurs inside the intact cornea, ReLEx is more independent of intraoperative ambient conditions. At the same time, the predictability of the results is better, which is particularly beneficial with high refraction values up to -10 diopters. Elaborate evaluations and empirical correction factors are a thing of the past.

One treatment step, maximum satisfaction – single-step.

With ReLEX smile, the lenticle and access are created in a single treatment step. For patients, this means a minimally invasive procedure. Because the entire refractive correction takes place on VisuMax, the patient does not have to be moved to another laser system. This minimizes stress and increases convenience. Doctors also benefit from shorter treatment times. Creating the lenticle takes just a little bit longer than a simple flap incision. Removing the lenticle also does not take much longer than opening the flap.

ReLEx smile: a minimally invasive technique in refractive surgery

ReLEx smile combines the latest femtosecond technology and precise lenticle extraction into one minimally invasive correction technique in refractive surgery. The unique contact glass from Carl Zeiss supports the gentle nature of the method as it is based on the shape of the corneal surface. This property and the non-scleral suction ensure gentle contact to the eye. This also has a positive influence on treatment convenience during the operation as trauma and temporary loss of vision are avoided due to use of a curved contact glass. “ReLEx is LASIK without the flap and PRK without pain,” says Dr. Rupal Shah, Clinical Director of the New Vision Laser Center in India, one of the first users of ReLEx.

ReLEx smile is now available for all refractive surgery practices. The treatment range of ReLEx smile is -0,50&-10,00 D (sphere), 0&5,00 D (cylinder) and -0,75&-10,00 D (spherical equivalent).